HomeMy WebLinkAbout12-17-10 (7)BUREAU Of INDIVIDUAL TAXES
PO BOX 280601 - ~.. _
HARRISBURG PA 17128-0601 ~1 `,°;; - ~; .~ '`
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MICHAEL J PH~LL~~S~' ' FA.
328 DEEFIELD RD
CAMP HILL PA 17011
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE N0. 21 10-1001
ACN 10162466
DATE 11-02-2010
EST. OF JOHN W PHILLIPS
SSN 184-24-5141
DATE OF DEATH 09-23-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
FN B BANK provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/benefic:iary of this account.
If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
Pennsylvania. Please call (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 290-0285660 Date 06-05-2006 To ensure proper credit to the account. two
Established copies of this notice must: accompany
payment to the Register of Wills. Make check
Account Balance $ 1 r 227 • 05 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to Tax $ 204.51 months of the decedent's date of death,
Tax Rate )( . 045 deduct a 5 percent discount on the tax due.
Anv Inheritance Tax due will become delinquent
Potential Tax Due ~` 9 • 20 nine months after the date of death.
PART TAXPAYER RESPONSE
a
FA.IL\t~R~,,,TO ~~~SPOND WILL~..I~ESULT~~~I,N AN OFFICIAL TAX ASSESSMENT
A. ^ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain.
C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
ONE
B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~ The above informs
Complete PART ~2 ion is incorrect and/or
and/or PART 3~ below. debts and deductions were paid.
PART If indicating a different tax rate, please state ~~~ ~'""~ OFFICIAL FUSE ONLY ~~~[]~AAF
relationship to decedent : ~~~~ PA DEPARTMENT OF REVENUE ~~~,
TAX
RE
TURN - COMPUTATION OF
TAX
ON JOINT/TRUST
ACCOUNTS
"PAD ~~~
LI~:E I. Date Established 1 _~
~ 1 ~
2 . Account Balance 2 $ ~~
~°' 2 ~~ ~ ~~
~
3. Percent Taxable 3 X ~~„ 3 ~~
t S
T
4
t t $ ~
4. o
ax
Amoun
ubjec +
~~ ~ ~
~~
5. Debts and Deductions 5 5 ~ ~
6. Amount Taxable 6 '~ 6 1 '~
``
7. Tax Rate 7 X 7 s.
8. lax Due 8 $
\, ,,
$
~: . s
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief. H O M E C ~~ 7 ) ~ ~ ~ ~ ro 6T
~.• ~ WORK C 'iT ) ~~S < 2 '7 7~ ~~/ 20710
G
,X PAY R SIGNATURE TELEPHONE NUMBER A E
TOTAL CEnter on Line 5 of Tax Computation) S